MEDICARE CONSUMERS

North Dakota Health Care Review, Inc., (NDHCRI) connects Medicare consumers to healthcare quality information.  We have a contract with Medicare to be the quality improvement organization for North Dakota.  NDHCRI strives to protect the healthcare rights of Medicare consumers. We work with doctors, hospitals, nursing homes, and home health agencies to improve the quality of medical care received by all people. 

It is important to us that people on Medicare receive the information necessary to be good health care consumers. Follow these links to find out information about benefits, rights, and responsibilities under Medicare:

Know Your Rights
Know Your Responsibilities
What To Do If You Feel You're Being Asked to Leave the Hospital Too Soon
How NDHCRI Can Help You
Preventive Benefits

Know Your Rights

As a Medicare consumer, you have the right to:

• Complete information about decisions affecting the care you receive and your Medicare coverage
• Hospital care as long as it is medically necessary
• Medical care that meets professionally-accepted standards of quality
• A written discharge plan that states what services you need after you leave the hospital
• Answers to your questions about any aspects of the quality of care you receive from Medicare-certified providers

If you feel you have been denied any of these rights, NDHCRI can help.  Read on to find out how.

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Know Your Responsibilities

As a Medicare consumer, you are responsible to:

• Talk to your doctor about your hospital stay and services you may need after you leave the hospital
• Understand your Medicare coverage and limitations
• Ask for “An Important Message from Medicare” when you are admitted to the hospital; this form describes your rights and responsibilities and how to contact NDHCRI if you have concerns or questions
• Be an educated consumer and take advantage of the preventive benefits provided by Medicare
• Take an active role in making changes that will help you lead a healthier life

What To Do When You Feel You’re Being Asked To Leave the Hospital Too Soon

Medicare pays the hospital based on your medical problem; not by the number of days you stay in the hospital.  How long you should stay in the hospital depends solely on your medical need.

If you are told you must leave the hospital before you feel well enough, you have a right to
appeal that decision by asking NDHCRI to review your case.

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How NDHCRI Can Help You

NDHCRI can help if you have Medicare and:

• Were denied admission to a hospital
• Wish to file a complaint about the quality of the care you received from any Medicare-certified provider
• Are told to leave the hospital before you feel well enough to leave
• Receive a generic/expedited determination notice called “Notice of Medicare Provider Noncoverage” while receiving services from a home health agency, hospice, skilled nursing facility, or comprehensive outpatient rehabilitation facility

NDHCRI can review concerns you have about the care provided by your doctor or health facility.  If you do not think you received quality care, you can request a FREE review of your care.  However, we encourage you to talk about your quality of care concerns with your doctor first. 

If you still are not satisfied, call NDHCRI.  Complaints may be filed by the you or someone on your behalf.  NDHCRI will investigate your concerns and follow up with the appropriate actions.

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RETURN TO HOME

BENEFICIARY HOTLINE

701-852-4231 (Minot area)
1-800-472-2902 (In North Dakota)
1-888-472-2902 (Outside North Dakota)

NORTH DAKOTA LINKS

Senior Health Insurance Counseling

Senior Medicare Patrol

ND Department of Human Services - Aging Services

Aging and Disability Resource-LINK